Pulmonary manifestations of Wegener granulomatosis

Long-term survival in patients Wegener granulomatosis has been dramatically improved by cytotoxic and corticosteroid therapy. Pulmonary complications in the course of therapy may represent active relapse, complications of extrathoracic disease, or treatment complications. In 18 patients seen over 15 years, presenting radiographic features included pulmonary nodules (n=8), symptomatic narrowing of the larynx, trachea, or major bronchi (n=4), parenchymal consolidation (n=2), interstitial patterns (n=2), and intrathoracic adenopathy (n=2). Of 16 instances of pulmonary relapse, one-third differed from the presenting manifestation. Complications relating to extrathoracic disease or diagnostic/therapeutic intervention occurred in 12 instances and were often clinically indistinguishable from relapse. As survival with Wegener granulomatosis increases, thoracic complications have become highly diverse and dictate early recognition to reduce morbidity